| NPI | 1235434739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5004732) |
| Additional Taxonomies | 208VP0000X (Licence: NC 194558) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5004732) | |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2024-01-07 |