| NPI | 1578543997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 201053) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 61706) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2021-11-10 |