| NPI | 1639426950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9490929) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 21960) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2018-07-23 |