| NPI | 1124305594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SP011755) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP011755) |
| Enumeration Date | 2011-11-12 |
| Last Update Date | 2024-01-04 |