| NPI | 1164742789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 18095) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 15020) |
| Enumeration Date | 2010-06-05 |
| Last Update Date | 2013-09-23 |