| NPI | 1013936525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9447935) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 5912) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024170510) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2017-03-21 |