| NPI | 1174850812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3008025) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AK 1340) |
| 363LF0000X Nurse Practitioner Family (Licence: TN 14450) | |
| Enumeration Date | 2009-11-16 |
| Last Update Date | 2020-12-04 |