| NPI | 1508850892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013179) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA TP005643C) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP008112) | |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2020-07-23 |