| NPI | 1508973991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: ID NP-641A) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: UT 6541979-4405) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2011-04-04 |