| NPI | 1053335596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP04573) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN066991) |
| 363L00000X Nurse Practitioner (Licence: LA AP04573) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2017-07-28 |