| NPI | 1700286796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19078) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 17833) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-09-24 |