| NPI | 1003809708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP01279) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM R53026) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2011-08-01 |