| NPI | 1104258326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007363) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171058) |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2015-01-20 |