| NPI | 1912306101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A103232) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP11232) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2018-06-07 |