| NPI | 1962785733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 18727) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024166115) |
| 363LF0000X Nurse Practitioner Family (Licence: CT 1753) | |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2020-11-13 |