| NPI | 1487641007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 201833) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC F66531) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: NC 201833) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2022-12-20 |