| NPI | 1104822733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 145991) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 201072) |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2019-06-20 |