| NPI | 1891836110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 3620) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 16084) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2011-11-01 |