| NPI | 1174560965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR A01264) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2005005588) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2020-03-13 |