| NPI | 1730411224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP05826) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA RN 080943) |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2014-01-17 |