| NPI | 1710315189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SP013277) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NE 111885) |
| 363LF0000X Nurse Practitioner Family (Licence: IA A141895) | |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2018-03-17 |