| NPI | 1568478550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA AP01767) |
| Additional Taxonomies | 363LS0200X Nurse Practitioner, School (Licence: LA AP01767) |
| 363LF0000X Nurse Practitioner, Family (Licence: LA AP01767) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2008-02-15 |