| NPI | 1275699142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11015902) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 16375) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2021-12-15 |