| NPI | 1164960167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 8104) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NV APRN002362) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2019-06-10 |