| NPI | 1154606234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: LA AP06083) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: LA RN107656) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2012-12-17 |