| NPI | 1780677161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IA A062100) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 062100) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2009-01-21 |