| NPI | 1043612310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SD CP000911) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA A070238) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2014-11-20 |