| NPI | 1316931470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A051825) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA F051825) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2009-07-08 |