| NPI | 1891768115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009719) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 001852) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2020-03-13 |