| NPI | 1003050675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA 137710) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2002005956) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2020-02-06 |