| NPI | 1811314636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 20769) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA F0314022) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2019-01-25 |