| NPI | 1679567507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA TP004126B) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA TP004126B) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2021-01-23 |