| NPI | 1073508313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 201370) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 89737) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2013-07-10 |