| NPI | 1710528328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5012371) |
| Additional Taxonomies | 208VP0000X (Licence: NC 5012371) |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2021-12-23 |