| NPI | 1073516779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 6096) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP04457) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2009-02-25 |