| NPI | 1114308632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ 248856) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NE 111807) |
| 363LF0000X Nurse Practitioner Family (Licence: MS 901679) | |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2021-03-25 |