| NPI | 1376550756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM R42143) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30000241) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-09-05 |