| NPI | 1336169499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: SC 4111) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN124405) |
| 363LF0000X Nurse Practitioner Family (Licence: GA R124405) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2011-10-13 |