| NPI | 1558714311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NC 5016415) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 307821) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2022-08-17 |