| NPI | 1306033899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 4090) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 878081) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2010-07-27 |