| NPI | 1194000620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: SC 23347) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 4840) |
| 363L00000X Nurse Practitioner (Licence: PA SP017163) | |
| Enumeration Date | 2011-10-16 |
| Last Update Date | 2020-12-22 |