| NPI | 1558365924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2003013076) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA A108719) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2007-07-09 |