| NPI | 1790753598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO 990845) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: TX 512966) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2020-01-23 |