| NPI | 1417090523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 2623012) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP2623012) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2018-02-26 |