| NPI | 1487743571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5004976) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 0001132012) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2011-08-10 |