| NPI | 1891151726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5009448) |
| Additional Taxonomies | 208VP0000X (Licence: NC 5009448) |
| 363L00000X Nurse Practitioner (Licence: SC 19902) | |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2018-10-15 |