| NPI | 1003982380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9375316) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA VP005573C) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2015-08-07 |