| NPI | 1487632063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SP007580) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 0050-00686) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2018-06-11 |