| NPI | 1659507713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 4307) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5004336) |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2013-07-24 |