| NPI | 1912417627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009993) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 21465) |
| Enumeration Date | 2017-10-08 |
| Last Update Date | 2020-08-31 |