| NPI | 1477995983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5010642) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024170859) |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2018-10-08 |