| NPI | 1609014406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11002041) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 20088005525) |
| 363LF0000X Nurse Practitioner Family (Licence: TN 14978) | |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2020-08-11 |