| NPI | 1891392510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 161396) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 161396) |
| 363LF0000X Nurse Practitioner Family (Licence: NC 5013654) | |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2020-10-08 |