| NPI | 1902934540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5008789) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 19846) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2021-03-29 |