| NPI | 1780122515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 9592106-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 13353) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2017-01-31 |