| NPI | 1902860075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP00094) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM R12264) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2012-02-01 |