| NPI | 1497138648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5008792) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 20094) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2016-08-05 |