| NPI | 1942857560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC LARSMKY6N8) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 273274) |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2019-08-19 |