| NPI | 1952704017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 19122) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5007201) |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2015-05-12 |