| NPI | 1134342553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11011666) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO 118940) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2022-05-18 |