| NPI | 1669662086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC APN355) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 248427) |
| 363LF0000X Nurse Practitioner Family (Licence: FL 9165739) | |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2021-02-23 |