| NPI | 1740588516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA AP07572) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY f305607-1) |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2015-01-09 |