| NPI | 1770822694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 203762) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 19090) |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2016-06-03 |