| NPI | 1265440580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 200478) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC Cert No 065049) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2016-09-13 |