| NPI | 1790999639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 1196) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC 01196) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-10-20 |