| NPI | 1639337918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11002209) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 110934) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2002016368) | |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2019-08-28 |