| NPI | 1538641105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MI 4704320911) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28161934A) |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2022-03-25 |