| NPI | 1568710994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014826) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012028464) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2021-09-21 |