| NPI | 1619453289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 21871) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5010828) |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-08-07 |