| NPI | 1366772089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP05982) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA RN097521) |
| Enumeration Date | 2009-12-31 |
| Last Update Date | 2011-01-11 |