| NPI | 1750990958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R190853) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R190853) |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2023-01-20 |