| NPI | 1194701276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 110221) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 34217) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2014-09-24 |