| NPI | 1114317526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-123290) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-123290) |
| Enumeration Date | 2015-01-24 |
| Last Update Date | 2020-02-24 |