| NPI | 1407400559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 11004028) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-142605) |
| 163W00000X Registered Nurse (Licence: FL RN9457625) | |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2020-12-07 |