| NPI | 1477690311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 110226) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A-115679) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2011-02-01 |