| NPI | 1295720092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SP008691) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MD R160912) |
| Enumeration Date | 2005-09-18 |
| Last Update Date | 2007-07-08 |