| NPI | 1063428449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS R865909) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AL 1-049783) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2014-04-02 |