| NPI | 1710935200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM R17788) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM R17788) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2008-05-20 |