| NPI | 1407230188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3011905) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 9429002) |
| 363LF0000X Nurse Practitioner Family (Licence: IL 209.012895) | |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2024-03-20 |