| NPI | 1962811679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WI 178643) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 5911) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2022-09-16 |