| NPI | 1861501132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS 861886) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS R861886) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-07-23 |