| NPI | 1194198234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5014538) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA NP95003632) |
| 363LF0000X Nurse Practitioner Family (Licence: TN APN0000020435) | |
| Enumeration Date | 2015-11-11 |
| Last Update Date | 2021-06-16 |