| NPI | 1609164193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5005536) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9318870) |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2018-03-17 |