| NPI | 1679913255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A120864) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A120864) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2013-09-12 |