| NPI | 1356385496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT NUR-RN-LIC-74827) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS R814478) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2015-07-30 |