| NPI | 1609193499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201150079NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 140581) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2013-11-22 |