| NPI | 1639750433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11012916) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9386496) |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2021-05-18 |