| NPI | 1407140569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AR A03542) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AR R73205) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2011-06-07 |