| NPI | 1235354572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 110793) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A116276) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2009-12-08 |