| NPI | 1134223324 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ RN125786) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 1449-033) | 
| Enumeration Date | 2006-09-11 | 
| Last Update Date | 2007-07-08 |