| NPI | 1033176714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5012785) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2001029398) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2020-02-19 |