| NPI | 1548696008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25008) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: SC PR37593) |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2021-07-19 |