| NPI | 1205161528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0994649) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 336091) |
| Enumeration Date | 2009-10-04 |
| Last Update Date | 2020-06-09 |