| NPI | 1629456355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 363LF0000X) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2015016932) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2017-05-12 |