| NPI | 1679756910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NM CNP01373) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM R57915) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NM CNP01373) | |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2018-06-16 |