| NPI | 1275088668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 20885) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 21569) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2017-07-13 |