| NPI | 1629332192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP06929) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN137659) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2015-04-08 |