| NPI | 1669871703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9469600) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171845) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2018-03-26 |