| NPI | 1629252044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AK 830) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 9197891) |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2023-11-08 |