| NPI | 1013986991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 3789) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R04165) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2019-04-01 |