| NPI | 1083025977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WI 5790) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WI 5790-33) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2022-05-13 |