| NPI | 1205205614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: ID 57251) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 3009683) |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2022-02-25 |