| NPI | 1134569338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SD CP001415) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CO 0990760) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2018-12-12 |