| NPI | 1023528460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA 115789) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC RN107817R) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2018-09-06 |