| NPI | 1972944015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9406028) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006278) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2015-05-13 |