| NPI | 1093826497 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 110115) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA 092180) | 
| Enumeration Date | 2006-08-31 | 
| Last Update Date | 2013-12-20 |