| NPI | 1780802215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AR AO2991 ANP) |
| Additional Taxonomies | 163WM0705X Registered Nurse Medical-Surgical (Licence: AR R66836) |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2007-09-19 |