| NPI | 1275515363 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA RN032217AP04266)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA RN032217AP04266)  | 
| 363L00000X Nurse Practitioner (Licence: WA AP60189618)  | |
| Enumeration Date | 2005-11-15 | 
| Last Update Date | 2013-07-17 |