| NPI | 1770827776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11015846) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 005213) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: CT 005213) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2023-01-05 |