| NPI | 1053627406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-149559) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 110731) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2016-11-22 |