| NPI | 1508253360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5007594) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5007594) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2016-12-08 |