| NPI | 1891047155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2013045361) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 75769) |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2018-01-17 |