| NPI | 1578887527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP05903) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA RN077487) |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2010-12-20 |