| NPI | 1609217348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: ND R50353) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC 18370) |
| 363LF0000X Nurse Practitioner Family (Licence: OH 17405) | |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2021-06-15 |