| NPI | 1962913822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5010046) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5010046) |
| 363LF0000X Nurse Practitioner Family (Licence: NC F10170580) | |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2019-10-28 |