| NPI | 1225587355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 104697) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 54187) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2017-10-10 |