| NPI | 1124483482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK F08191246) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 100656) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2019-09-09 |