| NPI | 1255478640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA RN055366AP02685) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: LA RN055366 AP02685) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2011-09-08 |