| NPI | 1578607925 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-095617) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-095617) | 
| Enumeration Date | 2007-02-19 | 
| Last Update Date | 2011-12-02 |