| NPI | 1194235044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9328313) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9328213) |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2018-03-17 |