| NPI | 1881698785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NM CNP00653) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM CNP00653) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NM R31674) | |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2018-03-09 |