| NPI | 1639724255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 61065) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC F06191299) |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2022-01-28 |