| NPI | 1467453704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 66823) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 114141) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2012-09-28 |