| NPI | 1700274016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R872057) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19413) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2016-02-19 |