| NPI | 1114179363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9272984) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 278330) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2017-01-27 |