| NPI | 1235114455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 19162) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: RI RN31335) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2016-07-07 |