| NPI | 1487923843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL #A0311067) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-083511) |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2013-12-16 |