| NPI | 1538239264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ AP2909) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN070242) |
| 163WE0900X Registered Nurse Enterostomal Therapy (Licence: AZ RN070242) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2008-06-16 |