| NPI | 1689661316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 900444) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 18560) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 900444) | |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2020-07-08 |