| NPI | 1073569638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: LA AP04079) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: LA RN093366) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2019-10-16 |