| NPI | 1871584136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5003513) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 201969) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2011-03-15 |