| NPI | 1467880922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 901969) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 18523) |
| Enumeration Date | 2013-10-21 |
| Last Update Date | 2019-06-21 |