| NPI | 1740508316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP06066) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA RN115555-AP06066) |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2019-07-30 |