| NPI | 1760460042 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9397231) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-037805) | 
| Enumeration Date | 2006-01-05 | 
| Last Update Date | 2016-10-11 |