| NPI | 1225057417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R26704) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ND R26704) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2017-04-18 |