| NPI | 1104261122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 006081) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9278186) |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2019-05-22 |