| NPI | 1013291491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5010926) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169667) |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2019-01-02 |