| NPI | 1063798163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP06681) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA RN094404) |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2011-11-03 |