| NPI | 1396040028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: ID 55603) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 19749) |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2017-05-10 |