| NPI | 1619968070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 100447) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 100447) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2007-08-20 |