| NPI | 1376072538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009558) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 5009558) |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2017-08-21 |