| NPI | 1124561212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 9316468) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA 95005171) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2022-04-01 |