| NPI | 1558546291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MO 2001022908) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: IA H151053) |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2025-03-11 |