| NPI | 1447220355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A057101) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 000731) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2011-07-18 |