| NPI | 1114408531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112598) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A152803) |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2018-10-03 |