| NPI | 1265916266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9410213) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL 9410213) |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2018-12-04 |