| NPI | 1598735300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO 105961) |
| Additional Taxonomies | 163WD0400X Registered Nurse Diabetes Educator (Licence: AK 105961) |
| 171000000X Military Health Care Provider (Licence: CO 105961) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2010-11-05 |