| NPI | 1750787495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024174088) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OK R0102675) |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2018-03-17 |