| NPI | 1720095086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-052430) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 12784) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2013-06-28 |