| NPI | 1154693091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 16497) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024169879) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2021-03-18 |