| NPI | 1770612350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NC 062371) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 100448) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2007-07-08 |