| NPI | 1891040135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 22900) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA RN2274503) |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2013-06-28 |