| NPI | 1497272421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21246) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010061) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2019-02-12 |