| NPI | 1588706659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 092309 NCBON) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 201816 NCMB) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2007-07-08 |