| NPI | 1639774730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R204095) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MD R204095) |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2023-04-14 |