| NPI | 1639513948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NC 5012667) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 5336) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2020-01-09 |