| NPI | 1508193780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 4170) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F0809225) |
| Enumeration Date | 2009-11-10 |
| Last Update Date | 2010-10-25 |