| NPI | 1245709260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 0233929) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2019000926) |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2020-05-12 |