| NPI | 1235767799 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 113176)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 2141)  | 
| Enumeration Date | 2020-03-31 | 
| Last Update Date | 2021-11-10 |