| NPI | 1508217498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024176367) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MD AC001815) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2019-06-14 |