| NPI | 1962488346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9306906) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 64621-030) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2011-03-01 |