| NPI | 1629338884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 264114) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5006829) |
| 363L00000X Nurse Practitioner (Licence: CT 4992) | |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2018-03-17 |