| NPI | 1962787416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP011638) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP0011638) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2015-06-08 |