| NPI | 1639283302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 59987) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 223876-4405) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2021-11-17 |