| NPI | 1205863677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: AZ RN178718) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 003149) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2019-01-08 |