| NPI | 1174139455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 28122) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MS 904141) |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2021-03-04 |