| NPI | 1194056143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007406) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 4105) |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2020-03-02 |