| NPI | 1770832636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA H-088255) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A-0712178) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2020-06-14 |