| NPI | 1396074464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 1785812) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP1785812) |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2012-01-04 |