| NPI | 1225096803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2018035923) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 110252) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2019-11-01 |