| NPI | 1215321559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5010917) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 19260) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2020-10-26 |