| NPI | 1518123769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A-120111) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 110964) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2009-07-29 |