| NPI | 1972590479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA 098303) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IA 098303) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2017-03-29 |