| NPI | 1124276233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 4183) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 675419) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2016-05-25 |