| NPI | 1952648826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5006023) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 175458) |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2014-07-24 |