| NPI | 1073030607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NE 112351) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 2004) |
| 363LF0000X Nurse Practitioner Family (Licence: IA A148987) | |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2018-06-12 |