| NPI | 1205830601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 096048) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA 107099) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2013-01-23 |