| NPI | 1104828326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 110820) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NE 110820) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2020-03-08 |