| NPI | 1669750444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP06569) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA RN115709) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2014-02-11 |