| NPI | 1912909151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 59788) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ RN083804) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2018-11-09 |