| NPI | 1912525114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD R210372) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD R210372) |
| 363L00000X Nurse Practitioner (Licence: MD R210372) | |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2020-07-14 |