| NPI | 1073976619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 20113) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 20113) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2016-06-16 |