| NPI | 1972961142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5012428) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 20892) |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2020-10-23 |