| NPI | 1053581538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO APN.0991766-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AZ AP3030) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2015-11-03 |