| NPI | 1962427609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA RN059895) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP04819) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2007-12-11 |