| NPI | 1679823090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP09734) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R872599) |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2021-10-05 |