| NPI | 1104059807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 003592) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 003592) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2010-04-23 |