| NPI | 1306140553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009675) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 15473) |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2017-11-02 |