| NPI | 1790246122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11028873) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-156750) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2024-02-15 |