| NPI | 1659848604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD 202685) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 2323583) |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2021-09-02 |