| NPI | 1073867958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A116572) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A-116572) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2021-12-03 |