| NPI | 1518221175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS 881262) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS R881262) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2020-08-11 |