| NPI | 1104052018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IN 71002970A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 3006312) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2019-11-19 |