| NPI | 1063769719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 32642) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024170245) |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2024-12-04 |