| NPI | 1083090666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009494) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: NC 5009494) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5009494) | |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2018-08-20 |