| NPI | 1669513032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9201611) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209007911) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2013-01-09 |