| NPI | 1205827326 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 181370) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 201679) | 
| Enumeration Date | 2005-10-31 | 
| Last Update Date | 2015-10-14 |