| NPI | 1912176280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 6184) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 74644) |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2016-11-07 |