| NPI | 1417645904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IA A176105) |
| Additional Taxonomies | 163WS0121X Registered Nurse Plastic Surgery (Licence: IA 10977) |
| Enumeration Date | 2023-04-24 |
| Last Update Date | 2023-09-29 |