| NPI | 1528355823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP-01736) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AZ AP4324) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2012-05-01 |