| NPI | 1710297205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8812) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 305410) |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2021-11-02 |