| NPI | 1396731220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NV APRN001626) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: VA 0024164098) |
| 363LF0000X Nurse Practitioner Family (Licence: VA 0024164098) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2015-12-14 |