| NPI | 1093858201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NC 182307) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 118572) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2009-03-11 |