| NPI | 1174609598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200850115NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID NP 304) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2014-08-12 |