| NPI | 1750581229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 14626) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 055681) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2012-05-14 |