| NPI | 1114232683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 111162) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NE 111162) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2012-06-28 |