| NPI | 1194895904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 111072) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F334562) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2010-04-02 |