| NPI | 1255782330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP08817) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN129789) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: LA AP08817) | |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2019-10-14 |