| NPI | 1922481894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 233239) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IN 71005545A) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2019-05-30 |