| NPI | 1164616553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP05283) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP05283) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: LA AP05283) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2014-10-02 |