| NPI | 1801877295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NM CNP00557) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 36827) |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2014-09-23 |