| NPI | 1710906078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004716) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ AP3710) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2019-01-29 |