| NPI | 1184942591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5004614) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5004614) |
| 363L00000X Nurse Practitioner (Licence: NC 5004614) | |
| Enumeration Date | 2010-05-10 |
| Last Update Date | 2013-02-01 |