| NPI | 1811025703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP-01998) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71002349A) |
| 163W00000X Registered Nurse (Licence: NM RN-75785) | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2015-09-23 |