| NPI | 1114923695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP00406) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM R23449) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2013-11-08 |