| NPI | 1154675866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5011848) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA RN261013) |
| Enumeration Date | 2012-11-02 |
| Last Update Date | 2020-06-25 |