| NPI | 1700111424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP05894) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA RN126708) |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2010-12-20 |