| NPI | 1215921366 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP3301392) | 
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: FL 0062584) | 
| Enumeration Date | 2005-09-06 | 
| Last Update Date | 2015-06-01 |