| NPI | 1578923199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC AGO116134) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD AC002424) |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2019-01-04 |