| NPI | 1336816123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A175916) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY 348349) |
| Enumeration Date | 2021-08-27 |
| Last Update Date | 2024-01-18 |