| NPI | 1679556567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 3431) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 201511) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2020-01-06 |