| NPI | 1639352123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R862697) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP01225) |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2009-07-08 |