| NPI | 1508860966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000254) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD 0251) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2017-06-20 |