| NPI | 1659825123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011861) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 7132) |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2021-07-21 |