| NPI | 1912918046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT RN10172) |
| Additional Taxonomies | 171W00000X Contractor (Licence: MT RN10172) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2009-08-13 |