| NPI | 1356546162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC F3199) |
| Additional Taxonomies | 208VP0000X (Licence: SC 3199) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2011-05-24 |