| NPI | 1366419459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 003178) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 003178) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2017-05-18 |