| NPI | 1063470417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 819101) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024114970) |
| 363L00000X Nurse Practitioner (Licence: CA 13826) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2019-05-16 |