| NPI | 1073540605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP203A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID N-19918) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2010-07-28 |