| NPI | 1366114027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5015491) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 253160) |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2023-01-04 |