| NPI | 1558617167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201508423NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP 4585) |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2015-12-11 |