| NPI | 1760711279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200950171NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013042953) |
| Enumeration Date | 2009-12-11 |
| Last Update Date | 2016-02-26 |