| NPI | 1104217306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9436052) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19582) |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2017-04-10 |