| NPI | 1295377224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11004061) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9408685) |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2020-05-13 |