| NPI | 1669773404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5004695) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 191652) |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2020-08-08 |