| NPI | 1205154952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 203824) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 4163) |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2020-09-09 |