| NPI | 1407380504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5009607) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 22559) |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2022-08-09 |