| NPI | 1528493053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R885813) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 17864) |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2016-04-08 |