| NPI | 1710996459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC APN 1202) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC APN1202) |
| 207P00000X Emergency Medicine (Licence: SC APN 1202) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2012-06-18 |