| NPI | 1881604643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5004429) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 304280) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2021-09-10 |