| NPI | 1962740118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SP012769) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA RN276641L) |
| Enumeration Date | 2013-01-23 |
| Last Update Date | 2018-08-09 |