| NPI | 1225276769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11003272) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL 5182385) |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2024-02-20 |