| NPI | 1710327812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA L073635) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 111518) |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2015-04-20 |