| NPI | 1558858381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5010440) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 5010440) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2018-06-11 |