| NPI | 1821289109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA 074302) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IA H074302) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-11-26 |