| NPI | 1104265263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP07408) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA TAP003162) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2016-06-28 |