| NPI | 1265417133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ AP4420) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC 61) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2014-06-26 |