| NPI | 1487080859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 265839) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: SC 209553) |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2017-10-26 |