| NPI | 1558530972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R871556) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-02611) |
| 363LF0000X Nurse Practitioner, Family (Licence: UT 8008588-4405) | |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2015-05-11 |