| NPI | 1639128952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 54858) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 054858) |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2010-11-12 |