| NPI | 1073666004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5005405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 216380) |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2020-07-16 |