| NPI | 1376537738 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 3649) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ RN091202) | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP 9194444) | |
| Enumeration Date | 2005-08-31 | 
| Last Update Date | 2009-03-09 |