| NPI | 1760617005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25520) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0001240478) |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2021-12-07 |