| NPI | 1013951318 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 18101) | 
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SC 3089) | 
| Enumeration Date | 2006-06-16 | 
| Last Update Date | 2013-05-20 |