| NPI | 1134127772 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 0293583-22)  | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM R11582)  | 
| Enumeration Date | 2005-07-08 | 
| Last Update Date | 2008-11-05 |