| NPI | 1255448213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 201607) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 174301) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 201607) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2016-12-27 |