| NPI | 1962720342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006697) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 19393) |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2015-08-06 |