| NPI | 1104248392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP-02321) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM R19639) |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2016-05-20 |