| NPI | 1770970873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19257) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5008474) |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2016-04-14 |