| NPI | 1770532004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011470) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 58078) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2022-01-05 |