| NPI | 1972728087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: LA RN045195) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP04281) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2007-07-08 |