| NPI | 1952817405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 9363125) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC 22869) |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2021-07-07 |