| NPI | 1013922707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT 36977) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 200250021NP FNP-PP) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2011-07-01 |