| NPI | 1164482568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 2563) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC F2563) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2020-02-27 |