| NPI | 1558488205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NH 030415-23) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 167288) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: MA 167288) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2021-04-05 |