| NPI | 1679799225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 258158) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 258158) |
| 363L00000X Nurse Practitioner (Licence: NC 258158) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2014-04-29 |