| NPI | 1245584622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11005280) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP012505) |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2021-07-29 |