| NPI | 1518977495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA VP004422C) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA VP004422C) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2019-05-09 |