| NPI | 1881677201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 121126) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ AP2085) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2013-04-11 |