| NPI | 1083079701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009904) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 5009904) |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2022-09-23 |