| NPI | 1730644733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MD R155156) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024180775) |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2021-09-20 |