| NPI | 1730507591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP07685) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN111461) |
| Enumeration Date | 2014-03-30 |
| Last Update Date | 2017-01-18 |