| NPI | 1174821383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK 1425) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 3385432) |
| Enumeration Date | 2011-03-11 |
| Last Update Date | 2020-10-01 |