| NPI | 1568540201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5012606) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 22340A) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2021-04-07 |