| NPI | 1619084647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5000682) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 0050-00682) |
| 363L00000X Nurse Practitioner (Licence: AL 1-130234) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2021-11-09 |