| NPI | 1386672012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP-5234A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 249072) |
| 363L00000X Nurse Practitioner (Licence: ID NP523A) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2025-02-20 |