| NPI | 1568665206 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 110904) | 
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: NE 42009) | 
| 363L00000X Nurse Practitioner (Licence: NE 110904) | |
| Enumeration Date | 2007-06-08 | 
| Last Update Date | 2015-11-02 |