| NPI | 1053546150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA H123302) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NE 110967) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2018-08-23 |