| NPI | 1700254497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO 0000478) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC 19677) |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2017-04-17 |