| NPI | 1942555172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A149390) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9218120) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2022-04-15 |