| NPI | 1144220062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM R37554, CNP00821) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM R37554) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2011-11-19 |