| NPI | 1891172615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ AP8665) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WI 6322) |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2021-04-19 |