| NPI | 1053556266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD 0218398) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R087029) |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2008-12-03 |