| NPI | 1639382179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT RN20521) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MT RN20521) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2007-07-08 |