| NPI | 1649548892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R858093) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP06674) |
| 363LF0000X Nurse Practitioner, Family (Licence: LA AP06674) | |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2016-06-10 |