| NPI | 1912533142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MD R209729) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WV 105442) |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2022-01-26 |