| NPI | 1578048203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8575) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WI 8573-33) |
| Enumeration Date | 2018-09-28 |
| Last Update Date | 2022-06-28 |