| NPI | 1174633457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5006677) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5006677) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2016-02-11 |