| NPI | 1053720342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 19105) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MS R876849) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2020-11-02 |