| NPI | 1629313804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9286948) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CA 95003874) |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2018-08-01 |