| NPI | 1518155837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200950002np) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA sp009483) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA sp009646) | |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2011-09-09 |