| NPI | 1750396404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A-091009) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 105928) |
| 363L00000X Nurse Practitioner (Licence: SD CP000498) | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2011-09-28 |