| NPI | 1689058265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5007774) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024173291) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2022-07-07 |