| NPI | 1215939293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP04034) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA RN068456) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2009-06-10 |