| NPI | 1295251494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112316) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A148681) |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2017-12-12 |