| NPI | 1609905983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5002900) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 214803) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 0050-02900) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2021-08-09 |