| NPI | 1699083998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R879208) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 15924) |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2017-01-26 |