| NPI | 1114205424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5005513) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP011400) |
| 363L00000X Nurse Practitioner (Licence: NC 5005513) | |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2020-12-29 |