| NPI | 1376953919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 229213) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC CROY-774NKT) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 229213) | |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2016-12-28 |