| NPI | 1174173041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 2666632) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 266632) |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2019-11-09 |