| NPI | 1275977415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9365462) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 18065) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2018-04-13 |