| NPI | 1205895836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9302618) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024165755) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2011-04-13 |