| NPI | 1699802637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO 161915) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AZ AP4428) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2012-11-28 |