| NPI | 1407219470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009967) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 20097A) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2024-01-10 |