| NPI | 1558595025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP05579) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA RN114727) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2009-05-14 |