| NPI | 1649274002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 200614) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 200614) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2018-04-24 |