| NPI | 1174521702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR 219426) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO 80977) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2023-07-13 |