| NPI | 1497928592 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP05622) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R859605) | 
| Enumeration Date | 2008-04-09 | 
| Last Update Date | 2018-07-03 |