| NPI | 1316147507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 135883) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 201209) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2021-04-28 |