| NPI | 1215379706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 19265) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS A810521) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2015-02-05 |