| NPI | 1093239659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL 9293701) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9293701) |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2018-05-03 |