| NPI | 1770891830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 111415) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA L132325) |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2016-06-14 |