| NPI | 1164546727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1037156) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9191309) |
| 163W00000X Registered Nurse (Licence: AL 1037156) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2008-01-25 |