| NPI | 1952300451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 110292) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 32331) |
| 363L00000X Nurse Practitioner (Licence: IA A101261) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2012-10-25 |