| NPI | 1952911059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 28220) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000162283) |
| 363L00000X Nurse Practitioner (Licence: MS 904300) | |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2021-01-07 |