| NPI | 1578672697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 18719) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA TP005683B) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2021-07-06 |