| NPI | 1770993388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5006864) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 18750) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2020-10-28 |