| NPI | 1922305143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 111221) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A100022) |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2019-05-07 |