| NPI | 1104147461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9307486) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9307486) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2014-03-12 |