| NPI | 1407163868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 15254) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 136976) |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2012-01-09 |