| NPI | 1750759833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5007948) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 20068) |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2020-10-26 |