| NPI | 1912327040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006835) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5006835) |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2017-03-10 |