| NPI | 1720269806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 3415252) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 003711) |
| Enumeration Date | 2007-11-17 |
| Last Update Date | 2015-06-09 |