| NPI | 1770714669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 05865) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA 086301) |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2017-02-16 |