| NPI | 1760556112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: FL 2225182) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 2225182) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2014-05-12 |