| NPI | 1568831550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 20422) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024173041) |
| Enumeration Date | 2015-09-19 |
| Last Update Date | 2016-03-29 |