| NPI | 1104897412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WI 1704-033) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4704200437) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2018-05-07 |