| NPI | 1710072913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 56762) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 900073) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2015-10-26 |