| NPI | 1558639294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO 993239) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IN 28144376A) |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2022-02-10 |