| NPI | 1487639712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A-061686) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA C-061686) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2017-01-23 |