| NPI | 1649535626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 18687) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA sp012176) |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2018-03-17 |