| NPI | 1720193675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MS R734417) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R734417) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2007-07-16 |