| NPI | 1750412003 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP 02060)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN 043469)  | 
| Enumeration Date | 2007-03-08 | 
| Last Update Date | 2013-08-05 |