| NPI | 1609217793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 230135) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC F0713305) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2014-01-13 |