| NPI | 1760796148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS R893861) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-106412) |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2013-06-11 |