| NPI | 1376779090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A099381) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ND R38041) |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2012-10-02 |