| NPI | 1508305541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A149465) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28212530a) |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2018-03-21 |