| NPI | 1861878100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9469159) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3009564) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2018-11-20 |