| NPI | 1619942257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WI 3572) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SD 0330) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2010-01-26 |