| NPI | 1669722203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 3078392) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ TAP4608) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2022-07-21 |