| NPI | 1245393933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704212190) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4704212190) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2015-09-17 |