| NPI | 1962672485 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 17541)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP3067902)  | 
| Enumeration Date | 2008-03-12 | 
| Last Update Date | 2011-08-02 |