| NPI | 1679240972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA H164554) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 119640) |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2021-08-24 |