| NPI | 1104339829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NH 072312-23) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CT 7347) |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2018-06-28 |