| NPI | 1457791642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-101114) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AL 1-101114) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2016-07-14 |