| NPI | 1174846034 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R200534) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F305181) | 
| Enumeration Date | 2010-03-08 | 
| Last Update Date | 2012-10-16 |