| NPI | 1740458975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19553) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 13290) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2016-06-29 |