| NPI | 1114203254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9423463) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 70863) |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2016-09-06 |