| NPI | 1053509273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: ND R23525) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ND R23525) |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2018-11-09 |