| NPI | 1376167114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 65133) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID N-40995) |
| Enumeration Date | 2020-06-06 |
| Last Update Date | 2020-07-23 |