| NPI | 1215119359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2009034027) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 3256-33) |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2015-04-20 |