| NPI | 1104267251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-074486) |
| Additional Taxonomies | 163WG0100X Registered Nurse, Gastroenterology (Licence: AL 1-074486) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2018-09-26 |