| NPI | 1164856514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006456) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F0713741) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2020-05-26 |