| NPI | 1467684464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 37983.1528) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 62723) |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2020-10-05 |