| NPI | 1689621286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 0050-00980) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP009364) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA RN580910L) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2007-10-23 |