| NPI | 1124367636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3016053) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA 95002648) |
| 363LF0000X Nurse Practitioner Family (Licence: MO 2008021121) | |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2022-02-18 |