| NPI | 1336162239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 200843) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 148711) |
| 363L00000X Nurse Practitioner (Licence: NC 200843) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2012-07-17 |