| NPI | 1154479236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL AL 1-068901) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-068901) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2017-01-28 |