| NPI | 1902251184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP08803) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN136435) |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-06-07 |