| NPI | 1639433287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 17816) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 5006066) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2021-02-17 |