| NPI | 1679979660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-121810) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-121810) |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2019-12-30 |