| NPI | 1649525932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5005715) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F0612213) |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2017-03-07 |