| NPI | 1205241411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 111694) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NE 111694) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2022-01-10 |