| NPI | 1407152754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 9353443) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MS R874100) |
| Enumeration Date | 2011-02-03 |
| Last Update Date | 2015-03-03 |