| NPI | 1902912413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM R09241) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NM I-05508) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2011-12-15 |