| NPI | 1760978464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112574) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA F159010) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2021-02-08 |