| NPI | 1316125800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: TN 15138) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 135337) |
| 363LF0000X Nurse Practitioner Family (Licence: AL 1-111220) | |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2019-02-08 |