| NPI | 1376983700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5006339) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 189737) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: NC 189737) | |
| Enumeration Date | 2013-06-29 |
| Last Update Date | 2020-11-19 |