| NPI | 1679766224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 200850116) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200340678) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2017-02-21 |