| NPI | 1497144968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 19236) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 3009180) |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2015-01-21 |