| NPI | 1144599341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP06491) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA F0511193) |
| 363L00000X Nurse Practitioner (Licence: LA RN113464) | |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2019-01-22 |