| NPI | 1114099124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NM CNP00969) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NM R42279) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2016-02-01 |