| NPI | 1720502040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009779) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 242054) |
| Enumeration Date | 2017-07-28 |
| Last Update Date | 2022-03-07 |