| NPI | 1730665563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA F07181499) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA F07181449) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2018-07-16 |