| NPI | 1629040290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 180954) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 904983) |
| 363L00000X Nurse Practitioner (Licence: LA AP08790) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2023-01-04 |