| 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 |