| NPI | 1639553639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: LA AP08358) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 902402) |
| 363LF0000X Nurse Practitioner, Family (Licence: LA AP08358) | |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2018-08-20 |