| NPI | 1124359021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5004969) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-104989) |
| Enumeration Date | 2010-01-18 |
| Last Update Date | 2019-01-31 |