| NPI | 1003998873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 13178) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1040028) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2012-11-05 |