| NPI | 1063641298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5004431) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 19907) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2019-02-12 |