| NPI | 1063962728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 21722) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024174210) |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2023-05-31 |