| NPI | 1255873329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IA A145950) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WI 7263-33) |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2018-03-17 |