| NPI | 1639860653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 77797) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11026106) |
| Enumeration Date | 2023-05-19 |
| Last Update Date | 2024-10-03 |