| NPI | 1407463300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MD R175876) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC RN1011264) |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2021-02-25 |