| NPI | 1992027064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007731) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA NP 17918) |
| Enumeration Date | 2010-02-17 |
| Last Update Date | 2015-09-09 |