| NPI | 1053640342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2009038441) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NV 2009038441) |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2021-10-19 |