| NPI | 1386637577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 0327586) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 105507) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2011-01-07 |