| NPI | 1699107912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 20391) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 5006365) |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2016-11-22 |