| NPI | 1174810691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN 5858) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN APN0000015858) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2021-04-15 |