| NPI | 1710503495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL 9315047) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11008191) |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-08-11 |