| NPI | 1629479043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5010190) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP014055) |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2018-06-26 |