| NPI | 1639745581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5018445) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD 248187) |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2023-11-14 |