| NPI | 1205156627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5004761) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F0510063) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2019-05-01 |