| NPI | 1174707236 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 265850) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP05328) | 
| 363L00000X Nurse Practitioner (Licence: SC 3777) | |
| 363L00000X Nurse Practitioner (Licence: FL ARNP9265595) | |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN153816) | |
| Enumeration Date | 2007-12-26 | 
| Last Update Date | 2018-03-15 |