| NPI | 1487938122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95011496) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OK 65980) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209-008986) | |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2020-04-20 |