| NPI | 1104068824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA RN077111) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP05760) |
| Enumeration Date | 2009-03-26 |
| Last Update Date | 2009-11-02 |