| NPI | 1265422661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 201488) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 201488) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 201488) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2022-02-01 |