| NPI | 1780296632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 28514) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5013670) |
| Enumeration Date | 2020-08-21 |
| Last Update Date | 2024-06-24 |