| NPI | 1780903476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 111332) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 500-4645) |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2012-04-13 |