| NPI | 1154568731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5004274) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 13852) |
| Enumeration Date | 2009-01-19 |
| Last Update Date | 2009-12-01 |