| NPI | 1154395929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NE 110996) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SD CP000416) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2009-12-07 |