| NPI | 1659480762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IA 102835) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: MO 068159) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-07-08 |