| NPI | 1669996807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5010710) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 21194) |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2020-04-20 |