| NPI | 1366794364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP09985) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN097873) |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2019-06-12 |