| NPI | 1548979495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5021081) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001277447) |
| Enumeration Date | 2022-11-18 |
| Last Update Date | 2024-11-13 |