| NPI | 1790718476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IN 71000879A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4704170056) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2016-07-29 |