| NPI | 1790200236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A130234) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA F06171144) |
| Enumeration Date | 2017-08-06 |
| Last Update Date | 2023-11-06 |