| NPI | 1164962288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AL 1-122021) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN264897) |
| Enumeration Date | 2017-03-08 |
| Last Update Date | 2018-01-03 |