| NPI | 1700223922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 19577) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN276827) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2018-04-16 |