| NPI | 1639172018 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9353309) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS R623768) | 
| Enumeration Date | 2005-05-31 | 
| Last Update Date | 2016-10-17 |