| NPI | 1770711582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 111026) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A154344) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2019-04-18 |