| NPI | 1770707523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2004002504) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A111977) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2019-09-30 |