| NPI | 1629242581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9250687) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 278683) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2009-04-30 |