| NPI | 1649985672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5019357) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 28002) |
| Enumeration Date | 2023-01-13 |
| Last Update Date | 2024-01-02 |