| NPI | 1689804239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MT 128682) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 200950085NP) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2018-03-17 |