| NPI | 1093064834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP07014) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA RN103357) |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2022-01-31 |