| NPI | 1194047829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R874307) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA RN124893-AP05859) |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2021-04-19 |