| NPI | 1073608790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5007078) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 220388) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-07-20 |