| NPI | 1043501604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 76530) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH COA 12290 NP) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2019-08-23 |