| NPI | 1508206863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: HI 3081) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: HI 85540) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: HI 28) | |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2022-03-10 |