| NPI | 1053495580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 17956) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0001137987) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2022-01-27 |