| NPI | 1982696050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP364A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 3743) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2015-03-24 |