| NPI | 1053475194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 111111) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD CP000479) |
| 363L00000X Nurse Practitioner (Licence: AK 945) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2017-04-05 |