| NPI | 1780983445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2011003656) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 75664) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2016-03-31 |