| NPI | 1770969164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SD CP000952) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA A153171) |
| 363LF0000X Nurse Practitioner Family (Licence: NE 113080) | |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2021-02-15 |