| NPI | 1538428172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 17719) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9390329) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2017-05-16 |