| NPI | 1306240387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9233828) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9233828) |
| 163W00000X Registered Nurse (Licence: GA RN224605) | |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2015-03-24 |