| NPI | 1962153544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11017630) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9347074) |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2022-08-24 |