| NPI | 1528050440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5010396) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 21739) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2022-01-05 |