| NPI | 1245861517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11007492) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 3397652) |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2020-06-11 |