| NPI | 1134124902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 6319) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 79070) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2009-10-09 |