| NPI | 1093840829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 20235) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| 163W00000X Registered Nurse (Licence: SC 211976) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2016-08-10 |