| NPI | 1871869149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201350058NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP011979) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2016-08-24 |