| NPI | 1336807361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP024491) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-12-07 |
| Last Update Date | 2023-05-11 |