| NPI | 1336637602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R161985) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC RN1027130) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2021-02-01 |