| NPI | 1467475079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 14907) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 22046.0304) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2017-12-28 |