| NPI | 1124023833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA 067490) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 845) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2012-11-02 |