| NPI | 1922429000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 263680) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 18431) |
| Enumeration Date | 2013-12-17 |
| Last Update Date | 2014-08-07 |