| NPI | 1316024623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201050153NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 262067) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2013-03-05 |