| NPI | 1780716670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 234982) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC APRN 603) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5004566) | |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2015-11-16 |