| NPI | 1487631461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS R763321) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT R763321) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2016-08-23 |