| NPI | 1821360330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY f307240-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 645801-1) |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2022-04-01 |