| NPI | 1649550302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011713) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN253042) |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2021-10-05 |