| NPI | 1770584807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN1451072) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 031848-RN) |
| 363L00000X Nurse Practitioner (Licence: NC 200856) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 031848-RN) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2019-10-01 |