| NPI | 1962467456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA 059326) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 110627) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2015-07-27 |