| NPI | 1043364425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 169072) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 263364) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2013-09-12 |