| NPI | 1528636180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5014616) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC F01211189) |
| Enumeration Date | 2021-06-11 |
| Last Update Date | 2021-09-15 |