| NPI | 1912436007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 24382) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MN F05170820) |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2022-11-07 |