| NPI | 1700956265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-095841) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 3020) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2019-01-02 |