| NPI | 1972047330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010604) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201609331NP-PP) |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2018-08-09 |