| NPI | 1083990360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1018654) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NJ 26NJ00345700) |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2022-04-24 |