| NPI | 1689087678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5007930) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28177944A) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2019-07-09 |