| NPI | 1144350844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP-02419) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 110307) |
| 363L00000X Nurse Practitioner (Licence: NE 28326) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2014-08-19 |