| NPI | 1639134034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A089315) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 110700) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2021-06-14 |