| NPI | 1679823967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 111381) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA 131817) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2014-07-14 |