| NPI | 1902186968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 111830) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5005281) |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2017-01-03 |