| NPI | 1740694793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP07858) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN126231) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-06-18 |