| NPI | 1255396859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS 8100074) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN APN0000005418) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2012-09-27 |