| NPI | 1245540491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9491648) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 21882.1077) |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2020-02-07 |