| NPI | 1760813265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 901997) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1130647) |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2018-08-16 |