| NPI | 1487959573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009372) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 21870) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2019-02-12 |