| NPI | 1952445702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NE 110805) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 110805) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2019-08-05 |