| NPI | 1689183139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5012325) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 256364) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2021-09-27 |