| NPI | 1124430640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP07806) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: LA 07806) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2019-04-16 |