| NPI | 1336791862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WI 9627) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA A155591) |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-12-04 |