| NPI | 1467856930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19164) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC F1014216) |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2016-05-03 |