| NPI | 1669859146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5007617) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024172406) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2015-05-04 |