| NPI | 1730188277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 1155) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: SC 45938) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2015-12-08 |