| NPI | 1811467871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013667) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA 200291) |
| Enumeration Date | 2018-12-03 |
| Last Update Date | 2020-11-09 |