| NPI | 1790892586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 960032) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC OR48881) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2019-09-03 |