| NPI | 1700255916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R897736) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 0024172925) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2016-04-12 |