| NPI | 1306831094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA C064034 ARNP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA 064034 RN) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2007-11-28 |