| NPI | 1275776817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP05719) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA RN043992) |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2012-05-22 |