| NPI | 1053335034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5004295) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0001100660) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2021-04-12 |