| NPI | 1073750675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 20664) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CO 5985) |
| 363LF0000X Nurse Practitioner Family (Licence: FL 2222592) | |
| 363LF0000X Nurse Practitioner Family (Licence: TN 6980) | |
| Enumeration Date | 2009-01-19 |
| Last Update Date | 2012-02-03 |