| NPI | 1508068362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2022011602) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA A074677) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2022-07-08 |