| NPI | 1497799142 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: DC RN1025365) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R065756) | 
| Enumeration Date | 2006-06-15 | 
| Last Update Date | 2012-03-20 |