| NPI | 1407455363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5013835) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 261373) |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2020-12-10 |