| NPI | 1174982391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5008376) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5008376) |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2018-04-30 |