| NPI | 1972966992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO 0992352) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 1617166) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2020-03-06 |