| NPI | 1760580229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN9361689) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 44713) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2021-08-13 |