| NPI | 1811324049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007062) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 18504) |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2020-03-12 |