| NPI | 1336100254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 18124) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ RN058675) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2013-07-09 |