| NPI | 1790001469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 14927) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024169595) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2017-04-04 |