| NPI | 1124486550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA np95003366) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY f307210-1) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F307210) | |
| Enumeration Date | 2016-01-30 |
| Last Update Date | 2018-02-09 |