| NPI | 1285919910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5005410) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC 17604) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2020-09-14 |