| NPI | 1962005199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: TX 1019571) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: TX 1019571) |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2022-03-11 |