| NPI | 1467487629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 300001) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 041455) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2012-01-11 |