| NPI | 1578553962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN9495576) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: DE LG-0000453) |
| 363LF0000X Nurse Practitioner Family (Licence: MD R097401) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2021-12-01 |