| NPI | 1740603109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID RN57153) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID NP57153) |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2017-12-22 |