| NPI | 1225118078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A055923) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A-055923) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2011-07-06 |