| NPI | 1053311845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 486422) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 486422) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2010-08-16 |