| NPI | 1003102021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP06367) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA AP06367) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2011-12-21 |