| NPI | 1720211477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP05861) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA RN103726) |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2012-07-27 |