| NPI | 1275559817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP02803) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA RN055001) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2021-05-19 |