| NPI | 1376682195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19252) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 212050) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 0050-02423) | |
| 363L00000X Nurse Practitioner (Licence: SC 19252) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2017-02-22 |