| NPI | 1073523478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP00691) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM R33452) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2013-02-04 |