| NPI | 1174529150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19010) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP2574812) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2018-01-17 |