| NPI | 1790067486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R619264) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS R619264) |
| Enumeration Date | 2011-09-19 |
| Last Update Date | 2016-02-15 |