| NPI | 1215957733 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP-574A)  | 
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: ID P75359)  | 
| Enumeration Date | 2006-07-20 | 
| Last Update Date | 2014-04-14 |