| NPI | 1417910563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA C092530) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA 092530) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2008-01-30 |