| NPI | 1508322504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC MACK-18NGWV) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5011510) |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2024-04-12 |