| NPI | 1508121658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A117293) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 111374) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2015-09-17 |