| NPI | 1033479696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 1639A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID 51084) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2016-01-14 |