| NPI | 1225072580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DC RN43659) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD AC000217) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024071247) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2018-04-16 |