| NPI | 1366573503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: IA A103223) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A103233) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IA A103233) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2007-07-08 |