| NPI | 1992059059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 11618) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 77147) |
| Enumeration Date | 2012-10-28 |
| Last Update Date | 2014-10-13 |