| NPI | 1962752188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9451949) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 17807) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2020-01-08 |