| NPI | 1952955684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 904343) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 891932) |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2021-02-01 |