| NPI | 1194142075 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP07758) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP007758) | 
| Enumeration Date | 2014-03-28 | 
| Last Update Date | 2019-05-13 |