| NPI | 1265449128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO SNP 100095) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA AO92663) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2012-08-14 |