| NPI | 1407079817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 4316) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024164062) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5008466) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2016-04-27 |